Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures

ABSTRACT

A surgical instrument includes a housing, a shaft extending therefrom and supporting an end effector, a knife, and a trigger assembly. The knife is configured to translate between retracted and extended positions. The trigger assembly includes a trigger movable relative to the housing between un-actuated and actuated positions, and a linkage including an apex and first and second bases. The apex is rotatably coupled to the housing about a pivot. The first base is disposed on a first side of the apex and coupled to the trigger. The second base is disposed on a second side of the apex and coupled to the knife. In response to movement of the trigger from the un-actuated to the actuated position, the first base is moved proximally, the apex is rotated about the pivot, and the second base is moved distally to move the knife from the retracted to the extended position.

BACKGROUND

Technical Field

The present disclosure relates to surgical instruments and methods and,more particularly, to surgical instrument and methods for performingtonsillectomy, adenoidectomy, and other surgical procedures.

Background of Related Art

The tonsils and adenoids are part of the lymphatic system and aregenerally located in the back of the throat. These parts of thelymphatic system are generally used for sampling bacteria and virusesentering the body and activating the immune system when warranted toproduce antibodies to fight oncoming infections. More particularly, thetonsils and adenoids break down the bacteria or virus and send pieces ofthe bacteria or virus to the immune system to produce antibodies forfighting off infections.

Inflammation of the tonsils and adenoids (e.g., tonsillitis) impedes theability of the tonsils and adenoids to destroy the bacteria resulting ina bacterial infection. In many instances, the bacteria remain even aftertreatment and serve as a reservoir for repeated infections (e.g.,tonsillitis or ear infections).

A tonsillectomy and/or adenoidectomy may be performed when infectionspersist and antibiotic treatments fail. Persistent infection typicallyleads to enlarged tonsil tissue which may need to be removed since inmany cases the enlarged tissue causes airway obstruction leading tovarious sleep disorders such as snoring or, in some cases, sleep apnea.Some individuals are also born with larger tonsils that are more proneto cause obstruction. An adenoidectomy may also be required to removeadenoid tissue when ear pain persists, or when nose breathing orfunction of the Eustachian tube is impaired. Often times, tonsillectomyand adenoidectomy procedures are performed at the same time.

SUMMARY

As used herein, the term “distal” refers to the portion that is beingdescribed which is further from a user, while the term “proximal” refersto the portion that is being described which is closer to a user.Further, to the extent consistent, any of the aspects described hereinmay be used in conjunction with any or all of the other aspectsdescribed herein.

A surgical instrument provided in accordance with the present disclosureincludes a housing, a shaft extending distally from the housing, an endeffector assembly coupled at a distal end of the shaft, a knife slidablydisposed within the shaft, and a trigger assembly. The knife isconfigured to translate through the shaft and relative to the endeffector assembly between a retracted position and an extended position.The trigger assembly includes a trigger and a linkage. The trigger iscoupled to the housing and movable relative to the housing between anun-actuated position and an actuated position. The linkage defines atriangular configuration including an apex portion and first and secondbase portions. The apex portion is rotatably coupled to the housingabout a linkage pivot. The first base portion is disposed on a firstside of the apex portion and coupled to the trigger. The second baseportion is disposed on a second side of the apex portion and coupled tothe knife. In response to movement of the trigger from the un-actuatedposition to the actuated position, the first base portion is movedproximally, the apex portion is rotated about the linkage pivot, and thesecond base portion is moved distally to thereby move the knife from theretracted position to the extended position.

In an aspect of the present disclosure, the trigger is pivotably coupledto the housing about a pivot pin. In such aspects, the trigger ismovable about the pivot pin and relative to the housing through an arcdefined between the un-actuated and actuated positions.

In another aspect of the present disclosure, the first base portion iscoupled to the trigger via a first pin-slot engagement and the secondbase portion is coupled to the knife via a second pin-slot engagementsuch that movement of the trigger through the arc translates the knifelongitudinally.

In yet another aspect of the present disclosure, a movable handle iscoupled to the housing and movable relative to the housing to actuatethe end effector assembly. The movable handle, more specifically, may bepivotably coupled to the housing about the pivot pin.

In still another aspect of the present disclosure, the end effectorassembly includes first and second jaw members. One or both of the jawmembers is movable relative to the other between a spaced-apart positionand an approximated position for grasping tissue therebetween inresponse to movement of the movable handle relative to the housing.

In still yet another aspect of the present disclosure, in the extendedposition, the knife extends at least partially between the first andsecond jaw members to cut tissue grasped therebetween.

In another aspect of the present disclosure, at least one of the firstand second jaw members is adapted to connect to a source of energy fortreating tissue grasped between the first and second jaw members.

In yet another aspect of the present disclosure, at least one of thefirst and second jaw members defines a longitudinally-extending knifechannel configured to at least partially receive the knife therein inthe extended position.

In still another aspect of the present disclosure, at least one of thefirst and second jaw members defines a window in communication with thelongitudinally-extending knife channel thereof. In such aspects, in theextended position, the knife extends through the window to protrude froman exterior of the at least one of the first and second jaw members.

Another surgical instrument provided in accordance with the presentdisclosure includes a housing, a deployable member selectivelydeployable relative to the housing, and a trigger assembly. The triggerassembly includes a trigger and a linkage. The trigger is pivotablycoupled to the housing about a pivot pin and movable about the pivot pinrelative to the housing through an arc defined between an un-actuatedposition and an actuated position. The linkage defines a triangularconfiguration and includes an apex portion and first and second baseportions. The apex portion is rotatably coupled to the housing about alinkage pivot. The first base portion is disposed on a first side of theapex portion and coupled to the trigger via a first pin-slot engagement.The second base portion is disposed on a second side of the apex portionand coupled to the deployable member via a second pin-slot engagement.In response to movement of the trigger through the arc from theun-actuated position to the actuated position, the first base portion ismoved in a first direction, the apex portion is rotated about thelinkage pivot, and the second base portion is moved in a seconddirection opposite the first direction to thereby longitudinallytranslate the deployable member from a retracted position to an extendedposition.

In an aspect of the present disclosure, the deployable member is aknife. In such aspects, the surgical instrument may further include ashaft extending distally from the housing and an end effector assemblysupported at a distal end of the shaft. The knife, in such aspects, isslidably disposed within the shaft and configured to translate throughthe shaft and relative to the end effector assembly between theretracted and extended positions.

In another aspect of the present disclosure, the end effector assemblyincludes first and second jaw members, at least one of which is movablerelative to the other between a spaced-apart position and anapproximated position for grasping tissue therebetween.

In yet another aspect of the present disclosure, in the extendedposition, the knife extends at least partially between the first andsecond jaw members to cut tissue grasped therebetween.

In still another aspect of the present disclosure, at least one of thefirst and second jaw members defines a longitudinally-extending knifechannel configured to at least partially receive the knife therein inthe extended position.

In another aspect of the present disclosure, at least one of the firstand second jaw members defines a window in communication with thelongitudinally-extending knife channel thereof. In such aspects, in theextended position, the knife extends through the window to protrude froman exterior of the at least one of the first and second jaw members.

In still yet another aspect of the present disclosure, a movable handleis coupled to the housing and movable relative to the housing to movethe first and second jaw members between the spaced-apart andapproximated positions.

In another aspect of the present disclosure, the movable handle ispivotably coupled to the housing about the pivot pin.

In another aspect of the present disclosure, at least one of the firstand second jaw members is adapted to connect to a source of energy fortreating tissue grasped between the first and second jaw members.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects and features of the present disclosure described hereinwith reference to the drawings wherein:

FIG. 1 is a perspective view of a surgical instrument provided inaccordance with the present disclosure with jaw members of the endeffector assembly of the surgical instrument disposed in a spaced-apartposition;

FIG. 2 is a top view of the surgical instrument of FIG. 1 with the jawmembers disposed in an approximated position;

FIG. 3 is a side view of the surgical instrument of FIG. 1 with the jawmembers disposed in the approximated position;

FIGS. 4-6 are side views of the surgical instrument of FIG. 1illustrating various different configurations for operably grasping thesurgical instrument;

FIG. 7 is a rear, perspective view of the surgical instrument of FIG. 1with the jaw members disposed in the approximated position and a portionof the housing removed to illustrate the internal components thereof;

FIG. 8 is a front, perspective, partially-exploded view of the surgicalinstrument of FIG. 1 with the jaw members disposed in the approximatedposition and a portion of the housing removed to illustrate the internalcomponents thereof;

FIG. 9 is a rear, perspective view of the handle, trigger, and driveassemblies of the surgical instrument of FIG. 1 with a movable handle ofthe handle assembly disposed in an initial position and a trigger of thetrigger assembly disposed in an un-actuated position;

FIG. 9A is a rear, perspective view of a portion of the proximal end ofthe surgical instrument of FIG. 1 incorporating another configuration ofa drive assembly provided in accordance with the present disclosure;

FIG. 10 is a front, perspective view of the drive assembly, shaft, andend effector assembly of the surgical instrument of FIG. 1;

FIG. 11 is an enlarged, perspective view of the area of detail indicatedas “11” in FIG. 10;

FIG. 11A is a perspective view of another slider assembly provided inaccordance with the present disclosure and configured for use with thesurgical instrument of FIG. 1;

FIG. 12 is a rear, perspective, exploded view of the drive assembly,shaft, and end effector assembly of the surgical instrument of FIG. 1;

FIG. 13 is a transverse, cross-sectional view taken along section line“13-13” of FIG. 3;

FIG. 14 is an enlarged, perspective view of the distal end of thesurgical instrument of FIG. 1;

FIG. 15 is a side view of the distal end of the surgical instrument ofFIG. 1 with the jaw members disposed in the spaced-apart positionadjacent tissue to be grasped;

FIG. 15A is a side view of the distal end of the surgical instrument ofFIG. 1 with the jaw members disposed in the approximated positionpressed against tissue to be spread and/or dissected;

FIG. 15B is a side view of the distal end of the surgical instrument ofFIG. 1 incorporating another configuration of jaw members provided inaccordance with the present disclosure and disposed in the approximatedposition pressed against tissue to be spread and/or dissected;

FIG. 15B′ is an enlarged, side view of the distal ends of the jawmembers of FIG. 15B;

FIG. 15C is a side view of the distal end of the surgical instrument ofFIG. 1 incorporating yet another configuration of jaw members providedin accordance with the present disclosure and disposed in theapproximated position pressed against tissue to be spread and/ordissected;

FIG. 15C′ is a top view of one of the jaw members of FIG. 15C;

FIG. 15D is a side view of the distal end of the surgical instrument ofFIG. 1 incorporating still another configuration of jaw members providedin accordance with the present disclosure and disposed in theapproximated position pressed against tissue to be spread and/ordissected;

FIG. 15D′ is an enlarged, side view of the distal ends of the jawmembers of FIG. 15D;

FIG. 16 is a side view of the distal end of the surgical instrument ofFIG. 1 with the jaw members disposed in the approximated positiongrasping tissue at the distal ends thereof;

FIG. 16A is a side view of the distal end of the surgical instrument ofFIG. 1 with the jaw members disposed in the spaced-apart positionspreading and/or dissecting tissue;

FIG. 16B is a side view of the jaw members of FIG. 15B disposed in thespaced-apart position spreading and/or dissecting tissue;

FIG. 16C is a side view of the jaw members of FIG. 15C disposed in thespaced-apart position spreading and/or dissecting tissue;

FIG. 16D is a side view of the jaw members of FIG. 15D disposed in thespaced-apart position spreading and/or dissecting tissue;

FIG. 17 is an enlarged, perspective view of the area of detail indicatedas “17” in FIG. 1;

FIG. 18 is a front, perspective view of the distal end of the surgicalinstrument of FIG. 1 with the jaw members disposed in the spaced-apartposition;

FIG. 19 is a side, perspective view of the distal end of the surgicalinstrument of FIG. 1 with the jaw members disposed in the spaced-apartposition;

FIG. 20 is a side, perspective view of one of the jaw members of thesurgical instrument of FIG. 1 with a portion thereof removed;

FIG. 21 is a transverse, cross-sectional view of the jaw member of FIG.20;

FIG. 22 is a side, cross-sectional view taken along section line “22-22”of FIG. 1;

FIG. 22A is a side, cross-sectional view of the proximal end of thesurgical instrument of FIG. 1 incorporating another configuration of thetorsion spring provided in accordance with the present disclosure;

FIG. 23 is an enlarged, side, cross-sectional view of the area of detailindicated as “23” in FIG. 22;

FIG. 24 is an enlarged, side, cross-sectional view of the area of detailindicated as “24” in FIG. 22;

FIG. 25 is a perspective view of the surgical instrument of FIG. 1 withthe movable handle disposed in a compressed position and, accordingly,the jaw members disposed in the approximated position;

FIG. 26 is an enlarged, perspective view of the area of detail indicatedas “26” in FIG. 25;

FIG. 27 is a side, cross-sectional view of the proximal end of thesurgical instrument of FIG. 1;

FIG. 28 is an enlarged, side, cross-sectional view of the area of detailindicated as “28” in FIG. 27;

FIG. 29 is a perspective view of the distal end of the drive and knifeassemblies of the surgical instrument of FIG. 1 disposed in a positioncorresponding to the spaced-apart position of the jaw members;

FIG. 30 is a perspective view of the distal end of the drive and knifeassemblies of the surgical instrument of FIG. 1 disposed in a positioncorresponding to the approximated position of the jaw members;

FIG. 31 is a perspective view of the distal end of the drive and knifeassemblies as shown in FIG. 29 and further including one of the jawmembers disposed in the spaced-apart position;

FIG. 32 is a perspective view of the distal end of the drive and knifeassemblies as shown in FIG. 30 and further including one of the jawmembers disposed in the approximated position;

FIG. 33 is a perspective view of the distal end of the drive and knifeassemblies as shown in FIG. 29 and further including the jaw membersdisposed in the spaced-apart position;

FIG. 34 is a perspective view of the distal end of the drive and knifeassemblies shown in FIG. 30 and further including the jaw membersdisposed in the approximated position;

FIG. 35 is a top, perspective view of the proximal end of the surgicalinstrument of FIG. 1 with the movable handle disposed in an activatedposition and a portion of the housing removed to illustrate the internalcomponents thereof;

FIG. 36 is a top, perspective view of the proximal end of the surgicalinstrument of FIG. 1 with the trigger disposed in an actuated positionand a portion of the housing removed to illustrate the internalcomponents thereof;

FIG. 37 is a rear, perspective view of the handle, trigger, and driveassemblies of the surgical instrument of FIG. 1 with the movable handledisposed in the activated position and the trigger disposed in theactuated position;

FIG. 38 is a perspective view of the distal end of the drive and knifeassemblies of the surgical instrument of FIG. 1 with the knife assemblydisposed in an extended position;

FIG. 39 is a perspective view of the distal end of the drive and knifeassemblies as shown in FIG. 38 and further including the jaw membersdisposed in the approximated position; and

FIG. 40 is a top, cross-sectional view of the distal end of the driveand knife assemblies and including the jaw members, as shown in FIG. 39.

DETAILED DESCRIPTION

Referring generally to FIGS. 1-12, a surgical instrument provided inaccordance with the present disclosure is shown generally identified byreference numeral 10. Instrument 10, as described below, is configuredfor grasping, treating, and/or dissecting tissue and may find particularapplicability for use in performing tonsillectomy and/or adenoidectomyprocedures, although use of instrument 10 in various other surgicalprocedures is also contemplated and within the scope of the presentdisclosure.

With reference to FIGS. 1, 7, 8, and 12, instrument 10 generallyincludes a housing 20, a handle assembly 30, a trigger assembly 70, ashaft 80, an end effector assembly 100, a drive assembly 140, a knifeassembly 170, and an energy activation assembly 190. As detailed below,shaft 80 extends distally from housing 20 and supports end effectorassembly 100 at distal end 85 thereof, drive assembly 140 operablycouples handle assembly 30 with end effector assembly 100 to enableselective manipulation of jaw members 110, 120 of end effector assembly100, knife assembly 170 is operably coupled with trigger assembly 70 toenable selective translation of a knife blade 174 of knife assembly 170relative to end effector assembly 100, and energy activation assembly190 enables energy to be selectively delivered to end effector assembly100.

Instrument 10 may also include an electrosurgical cable (not shown) thatconnects instrument 10 to a generator (not shown) or other suitablepower source, although instrument 10 may alternatively be configured asa battery-powered instrument. The electrosurgical cable includes leadwires, e.g., lead wires 107 (FIG. 12), extending therethrough that havesufficient length to extend through housing 20 and shaft 80 in order tooperably couple the generator, energy activation assembly 190, and endeffector assembly 100 with one another to enable the selective supply ofenergy to electrically-conductive plates 112, 122 of jaw members 110,120 of end effector assembly 100, e.g., upon activation of activationswitch 194 of energy activation assembly 190.

Referring to FIGS. 1-7, housing 20 houses the internal workingcomponents of instrument 10 and is formed from first and second housingcomponents 22 a, 22 b configured to engage one another via a pluralityof pin-aperture engagements 23 spaced around the perimeter of housing20. Housing 20 defines a pistol-style configuration having alongitudinally-extending barrel portion 24 and a fixed handle portion 26that extends from barrel portion 24 in generally perpendicularorientation relative thereto.

Housing 20, movable handle 40 of handle assembly 30, and trigger 72 oftrigger assembly 70 are ergonomically configured to enable operablegrasping of instrument 10 in a plurality of different positions. Housing20, more specifically, defines an elongated indentation 27 within barrelportion 24 on either side thereof, while a waist 28 is recessedannularly about handle portion 26 adjacent the interconnection betweenhandle portion 26 and barrel portion 24. Movable handle 40, morespecifically, defines a grasping portion 42 having an elongated proximalleg 43 that extends the length of fixed handle portion 26 of housing 20,a proximal foot 44 disposed at the free end of proximal leg 43 andangled distally relative to proximal leg 43, and an arcuate segment 45disposed at the opposite end of proximal leg 43 and extending distallytherefrom. Arcuate segment 45 culminates in a distal tail 46 and definesa sufficient diameter so as to operably receive a user's finger betweendistal tail 46 and proximal leg 43. Trigger 72, more specifically,includes a concave trigger surface 73 defining a saddle 74 configured tohelp retain a user's finger therein.

With particular reference to FIGS. 4-6, and initially to FIG. 4, in afirst operable grasping position, the user's hand is positioned suchthat the thumb is partially received within waist 28, the tip of theindex finger extends across trigger 72 and is partially received withinsaddle 74, the middle finger extends across movable handle 40 and ispositioned adjacent arcuate segment 45 of movable handle 40 betweenproximal leg 43 and distal tail 46, and the ring finger and pinky arepositioned distally of and adjacent to proximal leg 43. In thisposition, waist 28 inhibits slipping of the thumb, saddle 74 inhibitsslipping of the index finger, proximal leg 43 and distal tail 46 retainthe middle finger therebetween to enable both proximal and distalmovement of movable handle 40, proximal leg 43 provides a surfaceagainst which the ring finger and pinky can be utilized to urge movablehandle 40 proximally, and proximal foot 44 inhibits slipping of the ringfinger and pinky off the free end of movable handle 40.

Referring to FIG. 5, in a second operable grasping position, the user'shand is positioned such that the index finger is partially receivedwithin elongated indentation 27 on the opposite side of housing 20, themiddle finger extends transversely across trigger 72 and is partiallyreceived within saddle 74, the ring finger extends across movable handle40 and is positioned adjacent arcuate segment 45 of movable handle 40between proximal leg 43 and distal tail 46, and the pinky is positioneddistally of and adjacent to proximal leg 43. In this position, elongatedindentation 27 inhibits slipping of the index finger, saddle 74 inhibitsslipping of the middle finger, proximal leg 43 and distal tail 46 retainthe ring finger therebetween to enable both proximal and distal movementof movable handle 40, and proximal leg 43 provides a surface againstwhich the pinky can be utilized to urge movable handle 40 proximally.

Referring to FIG. 6, in a third operable grasping position, the user'shand is positioned such that the thumb is wrapped around a free end offixed handle portion 26 of housing 20, the index finger and middlefinger are positioned proximally of and adjacent the free end ofproximal leg 43 of movable handle 40, the ring finger extends acrossmovable handle 40 and is positioned adjacent arcuate segment 45 ofmovable handle 40 between proximal leg 43 and distal tail 46, and thepinky extends across trigger 72 and is partially received within saddle74. In this position, proximal foot 44 inhibits slipping of the indexfinger off the free end of movable handle 40, proximal leg 43 and distaltail 46 retain the ring finger therebetween to enable both proximal anddistal movement of movable handle 40, proximal leg 43 provides a surfaceagainst which the index and middle fingers can be utilized to urgemovable handle 40 proximally, and saddle 74 inhibits slipping of thepinky.

With reference to FIG. 7, fixed handle portion 26 of housing 20 definesa bay 29 a configured to receive and support energy activation assembly190, which is operable to initiate and terminate the delivery of energyto end effector assembly 100. Energy activation assembly 190 includes adepressible button 192 that is mechanically coupled to a switch 194mounted within bay 29 a of fixed handle portion 26 and is engagable by abutton activation post 196 extending proximally from a proximal side ofmovable handle 40 upon movement of the movable handle 40 to theactivated position, as detailed below. Switch 194 is configured toelectrically communicate with end effector assembly 100 and thegenerator (not shown) via suitable electrical wiring, e.g., leads 107(FIG. 12), extending through housing 20, shaft 80, and/or an externalcable (not shown) to enable energy to be supplied from the generator(not shown) to end effector assembly 100 upon activation of switch 194.

Referring additionally to FIG. 8, barrel portion 24 of housing 20defines a distal aperture 29 b (FIG. 7) configured to receive proximalend 82 of shaft 80 therein, and an engagement feature (not shown)extending inwardly from each of first and second housing components 22a, 22 b for receipt within opposed apertures 83 defined through proximalend 82 of shaft 80 for securing proximal end 82 of shaft 80 withinbarrel portion 24 of housing 20. Shaft 80 extends distally from housing20 and defines a generally rectangular cross-sectional configurationoriented such that the larger width dimension thereof extends laterallyand the smaller height dimension thereof extends vertically. Thisconfiguration of shaft 80 relative to the orientation of jaw members110, 120 (FIG. 7) provides an enhanced “line-of-sight” for visualizingthe surgical site adjacent end effector assembly 100. As described ingreater detail below, shaft 80 includes a pair of spaced-apart clevismembers 84 extending from the top and bottom walls, e.g., the largerwidth dimension walls, of shaft 80 at distal end 85 thereof, each ofwhich defines an aperture 86 for receiving a pivot pin 103 to operablysupport end effector assembly 100 at distal end 85 of shaft 80. In thisconfiguration, apertures 86 are vertically-aligned with one another.Shaft 80 further includes, as noted above, opposed apertures 83 definedthrough the side walls, e.g., the smaller height dimension walls, ofshaft 80 at proximal end 82 thereof for receiving engagement features(not shown) extending inwardly from first and second housing components22 a, 22 b to secure proximal end 82 of shaft 80 within housing 20.

Barrel portion 24 of housing further includes a pair of pivot apertures29 c, a longitudinal track 29 d (FIG. 13), a pivot boss 29 e, and aretention pin 29 f. Each pivot aperture 29 c is defined on theinwardly-facing surface of one of first and second housing components 22a, 22 b (only pivot aperture 29 c of first housing component 22 a isshown) and is configured to receive pivot pin 48 to pivotably couplemovable handle 40 and trigger 72 to housing 20. Longitudinal track 29 d(FIG. 13) is defined on the inwardly-facing surface of first housingcomponent 22 a and is configured to guide translation of drive assembly140 relative to housing 20. Pivot boss 29 e extends inwardly from firsthousing component 22 a and is configured to pivotably couple linkage 76of trigger assembly 70 to housing 20. Retention pin 29 f extendsinwardly from first housing component 22 a and is configured to retain afixed end 71 a of biasing member 71 of trigger assembly 70 in fixedposition relative to housing 20. The importance of these features ofbarrel portion 24 of housing 20 will become more apparent in view of thedescription below.

Turning to FIGS. 7-13, handle assembly 30 includes a movable handle 40that is movable relative to fixed handle portion 26 of housing 20between an initial position, a compressed position, and an activatedposition, as explained in greater detail below, to impart movement ofjaw members 110, 120 of end effector assembly 100 between a spaced-apartposition and an approximated position for grasping tissue therebetweenand for initiating the supply of energy to end effector assembly 100 fortreating grasped tissue. Movable handle 40 includes grasping portion 42,detailed above, which extends from housing 20 adjacent fixed handleportion 26, and flange portion 47, which extends upwardly into housing20. Flange portion 47 is pivotably coupled within housing 20 at the freeend of flange portion 47 via pivot pin 48. Pivot pin 48 is engagedwithin and extends between pivot apertures 29 c of first and secondhousing components 22 a, 22 b of housing 20 to permit movable handle 40to pivot about pivot pin 48 and relative to housing 20 between theinitial position, the compressed position, and the activated position.Pivot pin 48 is disposed on one side of, e.g., above, drive assembly140, while grasping portion 42 of movable handle 40 is disposed on theother side of, e.g., below, drive assembly 140, to provide a mechanicaladvantage when actuating movable handle 40.

Flange portion 47 of movable handle 40 further includes a cut-out 49defined therein and an engagement bulge 51 protruding therefrom. Cut-out49 is configured to slidably receive drive plate 142 of drive assembly140 and knife plate 172 of knife assembly 170. Engagement bulge 51 isconfigured to operably engage flange portion 47 of movable handle 40with slider assembly 150 of drive assembly 140, as detailed below.

Drive assembly 140 includes drive plate 142 and slider assembly 150.Drive plate 142 extends distally from housing 20 and through shaft 80 tooperably engage end effector assembly 100 such that, as detailed below,translation of drive plate 142 through shaft 80 and relative to endeffector assembly 100 pivots jaw members 110, 120 of end effectorassembly 100 between the spaced-apart and approximated positions. Sliderassembly 150 operably couples flange portion 47 of movable handle 40with drive plate 142 such that pivoting of movable handle 40 between theinitial position and the compressed position pivots jaw members 110, 120of end effector assembly 100 between the spaced-apart and approximatedpositions, while ensuring application of an appropriate closure force orclosure force within an appropriate closure force range to tissuegrasped between jaw members 110, 120 in the approximated positionthereof.

Slider assembly 150 includes a proximal housing 152, a distal extension154 extending distally from proximal housing 152, and a mandrel 156disposed at the distal end of distal extension 154. Proximal housing 152includes a post 153 a configured to receive a torsion spring 160thereabout, a first slot 153 b configured to retain a first leg 161 oftorsion spring 160 therein in fixed relation relative thereto, and asecond slot 153 c configured to operably receive second leg 162 oftorsion spring 160 therein. Proximal housing 152 further includes anabutment rib 153 d disposed thereon adjacent second slot 153 c, and aflange member 153 e configured for receipt within longitudinal track 29d (FIG. 13) of first housing component 22 a of housing 20.

Referring briefly to FIG. 11A, another slider assembly 2150 provided inaccordance with the present disclosure is similar to slider assembly 150(FIGS. 10-11) except for the configuration of the proximal housing andspring; thus, only these differences are detailed below. Proximalhousing 2152 of slider assembly 2150 is configured to house acompression spring 2160 therein. Compression spring 2160 defines a firstend 2161 and a second end 2162. First end 2161 of compression spring2160 is engaged with a vertical plate. Second end 2162 of compressionspring 2160 is engaged with an inner wall of proximal housing 2152. Inuse, compression spring 2160 functions similar to torsion spring 160(FIGS. 10-11), as detailed below, except that, rather than being furthertensioned via application of a torsional force thereto, compressionspring 2160 is further tensioned via application of a compressive forcethereto.

Returning to FIGS. 7-13, mandrel 156, as noted above, is disposed at thedistal end of distal extension 154 of slider assembly 150. Mandrel 156includes a pair of spaced-apart walls 157 defining a channel 158therebetween. Channel 158 is configured to receive engagement bulge 51of flange portion 47 of movable handle 40 while permitting verticalsliding of engagement bulge 51 within channel 158. As a result of thisconfiguration, upon pivoting of movable handle 40 between the initial,compressed, and activated positions, engagement bulge 51 is urged intocontact with one of the walls 157 defining channel 158 to therebytranslate slider assembly 150 within housing 20. The vertical sliding ofengagement bulge 51 within channel 158 during such urging ensures thatslider assembly 150 is translated longitudinally within and relative tohousing 20 despite the arcuate travel of movable handle 40 as movablehandle is pivoted about pivot pin 48 relative to housing 20.

Drive plate 142 includes a flange 143 disposed at the proximal endthereof. Flange 143 defines an aperture 144 configured to receive secondleg 162 of torsion spring 160 therein such that translation of secondleg 162 of torsion spring 160 relative to housing 20 effectscorresponding translation of drive plate 142 relative to housing 20.With respect to slider assembly 2150, vertical plate 2163 is engagedwithin a slot 2144 defined within drive plate 142 (see FIG. 11A), andfunctions in a similar manner as detailed below with respect to sliderassembly 150. Flange 143 further defines a proximal edge 145 configuredto abut abutment rib 153 d of proximal housing 152 in a proximal-mostposition of drive plate 142 relative to slider assembly 150 to inhibitfurther proximal movement of drive plate 142 relative to slider assembly150.

Drive plate 142, as mentioned above, extends distally from housing 20and through shaft 80 to operably engage end effector assembly 100. Driveplate 142 is oriented similarly to shaft 80, e.g., such that the widthof drive plate 142 extends along the width dimension of shaft 80. Driveplate 142 further defines a track edge 146 extending along a portion ofeach longitudinal side thereof. Track edges 146 are configured toslidably receive knife plate 172, as detailed below. A cam-pin aperture147 configured to receive a cam pin 105 associated with end effectorassembly 100 is defined transversely through drive plate 142 towards thedistal end of drive plate 142. A mouth 149 configured to receive a pivotpin 103 associated with end effector assembly 100 is defined at thedistal end of drive plate 142.

With momentary reference to FIG. 9A, as an alternative to providing aslider assembly that operably retains a torsion spring therein forcoupling to drive plate 142, a torsion spring 1160 may be operablycoupled between movable handle 40 and drive plate 142 without a sliderassembly. More specifically, in some embodiments, torsion spring 1160 ismounted about a post 1153 a extending transversely from movable handle40 and includes a first leg 1161 and a second leg 1162. First leg 1161of torsion spring 1160 is configured for receipt within an aperture 1144defined through drive plate 142 to operably couple movable handle 40with drive plate 142, while second leg 1162 of torsion spring 1160 isfixed relative to movable handle 40 via abutment with a protrusion 1153c thereof. In use, torsion spring 1160 operates similarly to torsionspring 160 (FIGS. 10-11) and, thus, a separate description of the use oftorsion spring 1160 is omitted as being superfluous.

With reference to FIGS. 14-21, as mentioned above, end effector assembly100 is operably supported at distal end 85 of shaft 80 and includesopposing jaw members 110, 120 pivotably coupled to one another andmovable relative to one another and shaft 80 between a spaced-apartposition and an approximated position for grasping tissue therebetween.Each jaw member 110, 120 includes an electrically-conductive plate 112,122, a jaw frame 113, 123, a spacer 115 (only spacer 115 of jaw member110 is shown (FIG. 21)), and an outer housing 118, 128, each of which isdetailed below. Jaw members 110, 120 define curved configurations,wherein jaw members 110, 120 bend upwardly from a longitudinal axis ofshaft 80, e.g., towards the upper, larger width dimension wall of shaft80. This configuration facilitates use of instrument 10 in tonsillectomyand adenoidectomy procedures as well as other surgical procedures andallows for increased visualization of the surgical site in these andother procedures. Except where specifically noted otherwise, jaw members110, 120 define mirror-image configurations of one another.

Jaw frames 113, 123 of jaw members 110, 120 each include a pair ofspaced-apart proximal flanges 113 a, 123 a and a distal jaw support 113b, 123 b. Jaw frames 113, 123 are formed via stamping and made fromstainless steel, although other manufacturing processes and/or materialsfor forming jaw frames 113, 123 are also contemplated. Proximal flanges113 a of jaw member 110 are spaced-apart further than proximal flanges123 a of jaw member 120 so as to allow proximal flanges 123 a of jawmember 120 to be positioned between proximal flanges 113 a of jaw member110 during assembly. Further, the proximal flanges 113 a, 123 a of eachpair define aligned pivot apertures 114 a, 124 a and aligned cam slots114 b, 124 b. Pivot pin 103 of end effector assembly 100 is configuredfor vertical insertion through apertures 86 of clevis members 84 ofshaft 80 and pivot apertures 114 a, 124 a to pivotably couple jawmembers 110, 120 to shaft 80 and one another with jaw members 110, 120being laterally movable, e.g., along the larger width dimension of shaft80, between the spaced-apart and approximated positions. Pivot pin 103is configured to at least partially enter mouth 149 of drive plate 142to permit drive plate 142 to slide further distally relative to endeffector assembly 100 to a position wherein mouth 149 of drive plate 142at least partially surrounds pivot pin 103.

The cam slots 114 b of proximal flanges 113 a of jaw member 110 areoppositely angled relative to the cam slots 124 b of proximal flanges123 a of jaw member 120. Cam pin 105 of end effector assembly 100 isconfigured for insertion through each cam slot 114 b, 124 b as well ascam-pin aperture 147 of drive plate 142 to operable couple drive plate142 with jaw members 110, 120 such that translation of drive plate 142relative to jaw members 110, 120 pivots jaw members 110, 120 about pivotpin 103 and relative to one another and shaft 80 between thespaced-apart and approximated positions.

With particular reference to FIGS. 19-21, although only the features ofjaw member 110 or jaw member 120 are described below and/or illustratedin the figures, it is noted that jaw members 110, 120 defines amirror-image configurations of one another (unless specificallycontradicted herein) and, thus, any description and/or illustration ofone jaw member 110, 120 applies similarly to the other jaw member 110,120.

Distal jaw support 113 b of jaw frame 113 of jaw member 110 extendsdistally from proximal flange 113 a and defines a generally “L-shaped”configuration. Distal jaw support 113 b is configured to supportelectrically-conductive plate 112, spacer 115, and outer housing 118 ofjaw member 110 thereon. However, distal jaw support 113 b do not extenddistally the entire length of jaw member 110. Rather, distal jaw support113 b defines a length of about 50% to about 75% of the lengths ofelectrically-conductive plate 112, spacer 115, and outer housing 118such that about 25% to about 50% of the lengths of these componentsextend distally beyond distal jaw support 113 b.

Spacer 115 of jaw member 110 defines a generally “M-shaped”configuration, is formed from an electrically-insulative material, andis overmolded onto distal jaw support 113 b during a first overmold,although other manufacturing processes are also contemplated. Spacer 115defines a body 116 a and a pair of wings 116 b surrounding body 116 a.Spacer 115 is positioned to electrically-isolate electrically-conductiveplate 112 and distal jaw support 113 b from one another. A knife slot116 c extends longitudinally through body 116 a of spaced 115 and isgenerally centered relative to body 116 a. Knife slot 116 c is open onlyto the top of spacer 115, except for the distal portion thereof, whichextends beyond distal jaw support 113 b and is open on both the top andbottom sides thereof to provide a window 116 d. A support-receivingchannel 116 e extends longitudinally through body 116 a at a positionlaterally offset relative to knife slot 116 c so as to not interferetherewith. Support-receiving channel 116 e is open to the bottom ofspacer 115 and is configured to receive the upright of the “L-shaped”distal jaw support 113 b upon the first overmolding of spacer 115thereabout. Body 116 a of spacer 115 further defines a tunnel 116 fconfigured to permit passage of lead wire 107 therethrough.

The electrically-conductive plate 112, 122 of each jaw member 110, 120defines a generally planar tissue-contacting surface 112 a, 122 a, anelongated slot 112 b, 122 b extending through the respectivetissue-contacting surface 112 a, 122 a, a pair of legs 112 c, 122 cextending downwardly from each side of the respective tissue-contactingsurface 112 a, 122 b, and a distal edge 112 d, 122 d disposed at thedistal end of the respective tissue-contacting surface 112 a, 122 a.Electrically-conductive plates 112, 122 extend from the proximal heelsof jaw members 110, 120, e.g., the interface between flanges 113 a, 123a and the distal portions of jaw members 110, 120, to the distal tips ofjaw members 110, 120. Jaw housing 118 of jaw member 110 includes a pairof proximal tissue stops that extend therefrom about either side of jawmember 120 such that, in conjunction with the positioning ofelectrically-conductive plates 112, 122 at the proximal heel of jawmembers 110, 120, grasping of tissue proximally ofelectrically-conductive plates 112, 122 is inhibited.

Tissue-contacting surfaces 112 a, 122 a define a plurality ofspaced-apart recesses 112 e, 122 e therein that facilitate graspingtissue. Tissue-contacting surface 112 a of electrically-conductive plate112 of jaw member 110 and/or tissue-contacting surface 122 a ofelectrically-conductive plate 122 of jaw member 120 may further includea plurality of stop members 122 f disposed thereon. Stop members 122 fmay be constructed of a heat-resistant ceramic deposited onto thetissue-contacting surfaces 112 a, 122 a, an electrically non-conductiveplastic molded onto tissue-contacting surfaces 112 a, 122 a, anelectrical conductive material isolated from the respectivetissue-contacting surface 112 a, 122 a, or may be formed from and/ormanufactured in any other suitable fashion.

Each wing 116 b of spacer 115 of jaw member 110 defines a slot 116 g,open at the top end thereof, that is configured for receiving one of thelegs 112 c of electrically-conductive plate 112. Wire 107, which extendsthrough tunnel 116 f defined within spacer 115 is configured toelectrical connect to an underside of electrically-conductive plate 112towards the distal end thereof for enabling the selective supply ofenergy thereto. Wire 107 is configured to extend proximally throughshaft 80 and into housing 20, ultimately coupling to energy activationassembly 190 (FIG. 7) and/or extending through the cable (not shown) tocouple to the generator (not shown).

Outer housings 118, 128 are formed about jaw members 110, 120 via asecond overmold process, such that each outer housing 118, 128 partiallyencloses respective jaw members 110, 120 with the exception of a portionof the distal jaw support 113 b, 123 b thereof and the tissue-contactingsurface 112 a, 122 a thereof, which remain exposed. Further, legs 112 c,122 c of electrically-conductive plates 112, 122 of jaw members 110, 120and the spacers 115 (only spacer 115 of jaw member 110 is shown) thereofeach define a plurality of fill-apertures 122 g (only fill-apertures 122g of electrically-conductive plate 122 of jaw member 120 areillustrated) that, upon overmolding of outer housings 118, 128 aboutrespective jaw members 110, 120 are filled with the overmolded materialforming outer housings 118, 128 to lock the components of each jawmember 110, 120 in an assembled condition. Further, outer housings 118,128 define lengths extending along the sides of respective jaw members110, 120 and thicknesses that decrease in the proximal-to-distaldirection along the lengths thereof. Outer housings 118, 128 also definewindows 119, 129 that align with and communicate with the windows 116 dof the respective spacers 115 (only spacer 115 of jaw member 110 isillustrated) and the knife slots 112 b, 122 b of the respectiveelectrically-conductive plate 112, 122 thereof so as to define anopening 131, 132 extending through the distal portion of each jaw member110, 120 transversely relative to the plane defined by the respectivetissue-contacting surface 112 a, 122 a.

With outer housings 118, 128 formed about jaw members 110, 120,respectively, distal edges 112 d, 122 d of electrically-conductiveplates 112, 122 overlap the distal ends of outer housings 118, 128 suchthat, as illustrated in FIGS. 15 and 16, distal edges 112 d, 122 d canbe utilized to pinch tissue therebetween. In particular, thisconfiguration enables pinching of planar tissue structures that lacksubstantial protruding portions that would otherwise enable grasping,such as the tissue wall illustrated in FIGS. 15 and 16.

Referring to FIGS. 15A and 16A, jaw members 110, 120 may further beutilized to spread and/or dissect tissue. In order to do so, with jawmembers 110, 120 disposed in the approximated position, end effectorassembly 100 may be manipulated such that the distal tips of jaw members110, 120 are pressed into contact with tissue to be spread and/ordissected, as shown in FIG. 15A. Thereafter, jaw members 110, 120 aremoved to the spaced-apart position such that the distal ends of outerhousings 118, 128 of jaw members 110, 120, respectively, push tissue inopposite directions, thus spreading and/or dissecting tissue. Variousconfigurations of the distal ends of outer housings 118, 128 of jawmembers 110, 120 to further facilitate spreading and/or dissectingtissue are detailed below. As also detailed below, drive assembly 140(FIG. 12) defines a pre-loaded configuration wherein drive assembly 140(FIG. 12) is always under tension, such that backlash upon moving jawmembers 110, 120 from the approximated position back to the spaced-apartposition is eliminated. Such a configuration facilitates spreadingand/or dissecting tissue by allowing for a more smooth and consistenttransition of jaw members 110, 120 from the approximated position backto the spaced-apart position.

Turning to FIGS. 15B, 15B′, and 16B, in some embodiments, the distalends of outer housings 118, 128 of jaw members 110, 120 define cut-outsthat form shelves 118 b, 128 b between the distal ends of outer housings118, 128 and the body portions 118 a, 128 a of housings 118, 128,respectively. Shelves 118 b, 128 b, as shown in FIGS. 15B, 15B′, and 16Bfacilitate the retention of tissue via the distal ends of outer housings118, 128, thus inhibiting slipping of tissue and facilitating spreadingand/or dissecting tissue.

Referring to FIGS. 15C, 15C′, and 16C, in some embodiments, in additionto or as an alternative to including shelves 118 b, 128 b, the distalends of outer housings 118, 128 of jaw members 110,120 define extensions118 c, 128 c that are relatively narrow and relatively small-radiused ascompared to body portions 118 a, 128 a of housings 118, 128. Theseextensions 118 c, 128 c facilitate pressing the distal ends of jawmembers 110, 120 further into tissue (see FIG. 15C) to ensure arelatively large contact area of tissue against shelves 118 b, 128 bupon moving jaw members 110, 120 to the spaced-apart position (see FIG.16C), thus facilitating the spreading and/or dissecting of tissue.

With reference to FIGS. 15D, 15D′, and 16D, in some embodiments, thedistal ends of outer housings 118, 128 of jaw members 110, 120 arecut-back to define angled surfaces 118 d, 128 d that define an angle “φ”relative to the perpendicular extending from the distal ends of jawmembers 110, 120 (see FIG. 16D). Angled surfaces 118 d, 128 d, similarlyas with the previous embodiments, facilitate the pressing of the distalends of jaw members 110, 120 further into tissue (see FIG. 15D) as wellas the retention of tissue while spreading and/or dissecting tissue.

Referring again to FIGS. 7-12, trigger assembly 70, as mentioned above,is operably coupled to knife assembly 170 to enable selectivetranslation of knife blade 174 of knife assembly 170 relative to endeffector assembly 100. Trigger assembly 70 includes trigger 72 and alinkage 76. Trigger 72 includes a grasping portion 75 a which includesthe concave trigger surface 73, a pivot extension 75 b extendingupwardly from grasping portion 75 a, and a proximal extension 75 cextending proximally from grasping portion 75 a. Grasping portion 75 aalso includes a tab 75 d extending distally therefrom. Tab 75 d definesan aperture 75 e configured to retain movable end 71 b of biasing member71 therein. As noted above, fixed end 71 a of biasing member 71 isengaged via retention pin 29 f of first housing component 22 a ofhousing 20. In this manner, biasing member 71 serves to bias trigger 72distally towards an un-actuated position (FIG. 35).

Pivot extension 75 b of trigger 72 is pivotably coupled to housing 20via pivot pin 48, which is engaged within and extends between pivotapertures 29 c of first and second housing components 22 a, 22 b ofhousing 20. It is noted that pivot pin 48 is shared by both trigger 72and movable handle 40; that is, both trigger 72 and movable handle 40are pivotable about the same point relative to housing 20. Proximalextension 75 c of trigger 72 includes a post 75 f that, as detailedbelow, is operably engaged within cam slot 77 e of linkage 76.

Linkage 76 serves to operably couple trigger 72 with knife assembly 170such that pivoting of trigger 72 from the un-actuated position (FIG. 35)to the actuated position (FIG. 36) advances knife blade 174 relative toend effector assembly 100 to cut tissue grasped between jaw members 110,120, as detailed below. Linkage 76 defines a generally triangular-shapedconfiguration including an apex 77 a pointing in a distal direction anda base defining upper and lower corners 77 b, 77 c, respectively. Apex77 a includes a peg 77 d that is configured for receipt within pivotboss 29 e of first housing component 22 a to pivotably couple linkage 76relative to housing 20 about apex 77 a thereof. A cam slot 77 e, 77 f isdefined through linkage 76 adjacent upper and lower corners 77 b, 77 c,respectively. A coupling pin 78 operably couples cam slot 77 e withknife plate 172 of knife assembly 170. More specifically, coupling pin78 includes a cap 79 a defining a slot 79 c (FIG. 9) configured toreceive finger 173 of knife plate 172 and a rod 79 b that is operablyengaged within cam slot 77 e. As noted above, post 75 f of proximalextension 75 c of trigger 72 is operably engaged within cam slot 77 f.

As a result of the above-detailed configuration of trigger assembly 70,pivoting of trigger 72 between the un-actuated and actuated positions(FIGS. 35 and 36, respectively) urges linkage 76 to pivot relative tohousing 20 ultimately such that coupling pin 78 is urged to translatelongitudinally within and relative to housing 20. As finger 173 of knifeplate 172 is engaged with coupling pin 78, such longitudinal translationof coupling pin 78 is imparted to knife plate 172 for translating knifeblade 174 between retracted and extended positions (FIGS. 29-34 and38-40, respectively) relative to end effector assembly 100, as detailedbelow.

Knife assembly 170, as noted above, includes a knife plate 172 defininga finger 173 at the proximal end thereof. Knife plate 172 extendsdistally through housing 20 and shaft 80 atop drive plate 142 and isslidably engaged therewith via receipt of each end of knife plate 172within track edges 146 of drive plate 142. Knife assembly 170 furtherincludes knife blade 174 integrally formed with or otherwise engaged toknife plate 172 and extending distally therefrom. Knife blade 174defines a width less than the combined thickness of jaw members 110, 120at the proximal ends thereof but greater than or equal to the combinedthickness of jaw members 110, 120 at the distal ends thereof. Knifeblade 174 further defines an elongated opening 176 extendinglongitudinally therethrough. Elongated opening 176 permits knife blade174 to be slidably disposed about pivot pin 103 and cam pin 105. Morespecifically, elongated opening 176 defines a first portion 177 a havinga first width configured to slidably receive pivot pin 103 and a secondportion 177 b having a second width configured to slidably receive campin 105 but sufficiently small to inhibit receipt of the larger-diameterpivot pin 103 therein.

As appreciated in view of the above, handle assembly 30, slider assembly150 of drive assembly 1450, and trigger assembly 70 enable efficientassembly of instrument 10 in that these components may be operablypositioned within housing 20 and relative to one another via a top-downassembly process.

Turning now to FIGS. 22-40, the use and operation of instrument 10 isdescribed. Initially, as illustrated in FIGS. 22-24, 29, 31, and 33,movable handle 40 is disposed in the initial position and,correspondingly, jaw members 110, 120 are disposed in the spaced-apartposition. More specifically, with movable handle 40 in the initialposition, engagement bulge 51 is disposed in a distal-most position suchthat slider assembly 150 is disposed in a distal-most position. Withslider assembly 150 disposed in its distal-most position, torsion spring160 is less-tensioned and second leg 162 of torsion spring 160 retainsdrive plate 142 in a distal-most position. Torsion spring 160 isless-tensioned but not fully un-tensioned in the initial position ofmovable handle 40. This configuration maintains a pre-load on driveassembly 140 such that, as noted above, backlash due to the completeremoval of tension from torsion spring 160 as jaw members 110, 120 movefrom the approximated position back to the spaced-apart position iseliminated. Drive plate 142 is inhibited from moving proximally relativeto slider assembly 150 in this position due to the abutment of theproximal edge 145 of drive plate 142 with abutment rib 153 d of proximalhousing 152 of slider assembly 150. Further, in this distal-mostposition of drive plate 142, drive plate 142 maintains cam pin 105 atthe distal ends of cam slots 114 b, 124 b and, thus, jaw members 110,120 are maintained in the spaced-apart position.

Turning for the moment to FIG. 22A, in some embodiments, rather thanfirst leg 161 of torsion spring 160 (FIGS. 10-11) being fixed relativeto proximal housing 152 of slider assembly 150, a torsion spring 3160may be provided including a first leg 3161 that extends through a slot3153 b defined within proximal housing 152 and is positioned to abut ablock 3020 mounted within or monolithically formed with housing 20. As aresult of this configuration, torsion spring 3160 provides theadditional function of biasing slider assembly 150 distally, therebybiasing jaw members 110, 120 towards the spaced-apart position (see FIG.14). That is, upon movement of movable handle 40 to translate sliderassembly 150 proximally (see FIG. 9), first leg 3161 of torsion spring3160 is maintained in position via its abutment with block 3020, therebyfurther tensioning torsion spring 3160 such that, upon release ofmovable handle 40 (FIG. 9), torsion spring 3160 serves to bias sliderassembly 150 distally, thereby biasing jaw members 110, 120 towards thespaced-apart position (see FIG. 14). Further, multiple blocks 3020 maybe provided at different positions within housing 20 such that, duringassembly, first leg 3161 of torsion spring 3160 may be positioned toabut a selected one of the blocks 3020 to achieve a desired biasingforce.

Returning to FIGS. 22-24, 29, 31, and 33, trigger 72 is initially isdisposed in the un-actuated position and, accordingly, knife blade 174is disposed in the retracted position. More specifically, in theun-actuated position, trigger 72 is disposed in a distal-most positionunder the bias of biasing member 71 such that lower corner 77 c oflinkage 76, which is coupled to trigger 72 via engagement of post 75 fwithin slot 77 f, is disposed in a distal-most position. Since upper andlower corners 77 b, 77 c of linkage 76 are disposed on opposite sides ofapex 77 a, with lower corner 77 c disposed in its distal-most position,upper corner 77 b is disposed in a proximal-most position. With uppercorner 77 b disposed in its proximal-most position, knife plate 172 islikewise disposed in a proximal-most position due to the engagement ofpin 78 within slot 77 e. The proximal-most position of knife plate 172corresponds to the retracted position of knife blade 174, wherein knifeblade 174 is disposed between flanges 113 a, 123 a of jaw members 110,120 but does not extend distally therefrom so as to avoid interferencewith tissue disposed between jaw members 110, 120. Further, in thisposition, pivot pin 103 is disposed at the distal end of first portion177 a of opening 176 of knife blade 174 and cam pin 105 is likewisedisposed within first portion 177 a of opening 176.

With additional reference to FIGS. 25-28, 30, 32, and 34, in order tomove jaw members 110, 120 to the approximated position to grasp tissuetherebetween, movable handle 40 is pulled proximally towards fixedhandle portion 26 from the initial position (FIG. 22) to the compressedposition (FIG. 27). Upon such movement of movable handle 40 to thecompressed position, engagement bulge 51 of movable handle 40 is movesproximally relative to housing 20, thereby urging slider assembly 150proximally through housing 20. Torsion spring 160, in the less-tensionedstate, is translated proximally together with slider assembly 150 suchthat second leg 162 of torsion spring 160 pulls drive plate 142proximally in connection with the proximal translation of sliderassembly 150. In other words, at this point, slider assembly 150 anddrive plate 142 move in concert with one another. As drive plate 142 ispulled proximally, cam pin 105 is pulled proximally through cam slots114 b, 124 b such that jaw members 110, 120 are pivoted from thespaced-apart position to the approximated position to grasp tissuetherebetween.

As detailed above, movement of movable handle 40 from the initialposition (FIG. 22) to the compressed position (FIG. 27) similarlytranslates drive plate 142 proximally, thereby moving jaw members 110,120 to the approximated position to grasp tissue therebetween. Driveplate 142 is still inhibited from moving proximally relative to sliderassembly 150 in this position due to the abutment of the proximal edge145 of drive plate 142 with abutment rib 153 d of proximal housing 152of slider assembly 150.

At this point, with tissue grasped between jaw members 110, 120,instrument 10 may be utilized as a pliers to maneuver, manipulate,and/or reposition tissue. In particular, as noted above and illustratedin FIGS. 15 and 16, jaw members 110, 120 may be approximated adjacent awall of tissue to pinch tissue between the distal tips of jaw members110, 120 to enable maneuvering, manipulating, and/or repositioningthereof.

Referring to FIG. 35, in order to apply energy to tissue grasped betweenjaw members 110, 120 to treat tissue, movable handle 40 is compressedfurther towards fixed handle portion 26 to an activation position,wherein an appropriate closure force or closure force within anappropriate range, is achieved and energy activation is initiated. Asmovable handle 40 is moved further proximally relative to housing 20beyond the compressed position, an appropriate closure force or closureforce within an appropriate range is imparted to tissue grasped betweenelectrically-conductive plates 112, 122 of jaw members 110, 120regardless of the thickness or compressibility of tissue or the positionof movable handle 40. This is because, upon movement of movable handle40 from the compressed position towards the activation position, sliderassembly 150 is translated proximally while drive plate 142 ismaintained in position. In other words, upon movement of movable handle40 from the compressed position to the activated position, sliderassembly 150 and drive plate 142 no longer move in concert with oneanother. Rather, as detailed below, slider assembly 150 and drive plate142 are decoupled to permit relative motion therebetween.

The decoupling of slider assembly 150 and drive plate 142 to permitrelative motion therebetween is provided via torsion spring 160. Morespecifically, upon proximal movement of movable handle 40, a first forceis imparted from movable handle 40, through slider assembly 150, firstleg 161 of torsion spring 160, the body of torsion spring 160, andsecond leg 162 of torsion spring 160, to drive plate 142 to urge driveplate 142 in a proximal direction, while a second, opposite force actson drive plate 142 and, thus, second leg 162 of torsion spring 160 in adistal direction to resist further compression of tissue between jawmembers 110, 120. Once the second, opposite force exceeds the springforce of torsion spring 160, proximal movement of slider assembly 150 nolonger results in proximal movement of drive plate 142 but, rather,results in further tensioning of torsion spring 160, which absorbs theforce imparted thereto from movement of movable handle 40. Thus, oncethis point as been reached, further proximal translation of sliderassembly 150 urges first end 161 of torsion spring 160 proximally, whilesecond opposite force retains second leg 162 of torsion spring 160 inposition, thereby further tensioning torsion spring 160. Since secondleg 162 of torsion spring 160 is retained in position, drive plate 142is likewise retained in position despite the proximal translation ofmovable handle 40 and slider assembly 150.

It is noted that, during movement of movable handle 40 from the initialposition to the compressed position, as detailed above, the second,opposite force is less than the spring force of torsion spring 160 and,thus, slider assembly 150, first and second legs 161, 162 of torsionspring 160, and drive plate 142 move in conjunction with one another.Further, torsion spring 160 may be configured such that the second,opposite force exceeds the spring force of torsion spring 160 at a forcecorresponding to a closure pressure on tissue between 3 kg/cm² to 16kg/cm², as it has been found that closure forces within this rangefacilitate sealing of tissue grasped between jaw members 110, 120.However, other forces and/or force ranges are also contemplated, e.g.,for treating tissue in other manners (coagulating, cauterizing, etc.).

Continuing with reference to FIG. 35, upon achieving the activationposition of movable handle 40, button activation post 196 (FIG. 7) ofmovable handle 40 contacts depressible button 192 sufficiently so as todepress depressible button 192 into fixed handle portion 26 to activateswitch 194. Switch 194, as noted above, is disposed in electricalcommunication with the generator (not shown) and electrically-conductiveplates 112, 122 of jaw members 110, 120, respectively, such thatactivation of switch 194 initiates the supply of energy toelectrically-conductive plates 112, 122 to treat, e.g., coagulate,cauterize, and/or seal, tissue grasped therebetween.

Referring to FIGS. 36-40, once tissue has been treated or where it isonly desired to cut tissue, knife blade 174 may be advanced between jawmembers 110, 120 to cut tissue grasped therebetween. In order to advanceknife blade 174 from the retracted position to the extended position,trigger 72 is pulled proximally against the bias of biasing member 71from the un-actuated position to the actuated position. As trigger 72 ispulled proximally, post 75 f is pushed proximally to urge linkage 76 topivot counter-clockwise (from the orientation illustrated in FIG. 36)such that upper corner 77 b of linkage 76 is moved distally. Distalmovement of upper corner 77 b urges pin 78 to translate distally due tothe engagement of rod 79 b of pin 78 within slot 77 e of upper corner 77b of linkage 76. Distal translation of pin 78, in turn, urges knifeplate 172 distally due to the engagement of finger 173 of knife plate172 within cap 79 a of pin 78.

As detailed above, movement of trigger 72 from the un-actuated positionto the actuated position urges knife plate 172 distally. Morespecifically, knife plate 172 is urged distally such that knife blade174 is advanced distally from the retracted position to the extendedposition. As knife blade 174 is advanced distally, knife blade 174enters the knife slots of jaw members 110, 120 defined by the respectiveknife slots 112 b, 122 b of electrically-conductive plates 112, 122 andthe knife slots 116 c of the respective spacers 115 (only spacer 115 ofjaw member 110 is illustrated). As can be appreciated, translation ofknife blade 174 through the knife slots of jaw members 110, 120 to theextended position thereof divides tissue grasped between jaw members110, 120.

Due to the fact that knife blade 174 defines a width greater than orequal to the combined thickness of jaw members 110, 120 at the distalends thereof, as knife blade 174 is advanced distally through the knifeslots, knife blade 174 may extend at least partially through windows119, 129 and openings 131, 132 of jaw members 110, 120, depending uponthe thickness of tissue grasped between jaw members 110, 120 (see FIG.39). Further, as knife blade 174 is advanced distally, pivot pin 103 andcam pin 105 translate proximally along opening 176 eventually such thatcam pin 105 extends through second portion 177 b of opening 176. Aspivot pin 103 is too large to extend into second portion 177 b ofopening 176, interference therebetween defines the distal-most extent oftravel of knife blade 174. However, other components of knife assembly170 and/or trigger assembly 70 may additionally or alternatively inhibitthe extension of knife blade 174.

Upon release of trigger 72, trigger 72 and knife plate 172 are returnedproximally under the bias of biasing member 71 such that knife blade 174is returned to the retracted position. Thereafter, movable handle 40 maybe returned to the initial position to release the treated and/ordivided tissue.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Such systems employ various robotic elements to assistthe surgeon and allow remote operation (or partial remote operation) ofsurgical instrumentation. Various robotic arms, gears, cams, pulleys,electric and mechanical motors, etc. may be employed for this purposeand may be designed with a robotic surgical system to assist the surgeonduring the course of an operation or treatment. Such robotic systems mayinclude remotely steerable systems, automatically flexible surgicalsystems, remotely flexible surgical systems, remotely articulatingsurgical systems, wireless surgical systems, modular or selectivelyconfigurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

From the foregoing and with reference to the various figure drawings,those skilled in the art will appreciate that certain modifications canalso be made to the present disclosure without departing from the scopeof the same. While several embodiments of the disclosure have been shownin the drawings, it is not intended that the disclosure be limitedthereto, as it is intended that the disclosure be as broad in scope asthe art will allow and that the specification be read likewise.Therefore, the above description should not be construed as limiting,but merely as exemplifications of particular embodiments. Those skilledin the art will envision other modifications within the scope and spiritof the claims appended hereto.

What is claimed is:
 1. A surgical instrument, comprising: a housing; ashaft extending distally from the housing; an end effector coupled at adistal end of the shaft; a knife slidably disposed within the shaft, theknife configured to translate through the shaft and relative to the endeffector assembly between a retracted position and an extended position;and a trigger assembly, including: a trigger coupled to the housing andmovable relative to the housing between an un-actuated position and anactuated position; and a linkage defining a triangular configurationincluding an apex portion and first and second base portions, the apexportion rotatably coupled to the housing about a linkage pivot, thefirst base portion disposed on a first side of the apex portion andcoupled to the trigger, the second base portion disposed on a secondside of the apex portion and coupled to the knife, wherein, in responseto movement of the trigger from the un-actuated position to the actuatedposition, the first base portion is moved proximally, the apex portionis rotated about the linkage pivot, and the second base portion is moveddistally to thereby move the knife from the retracted position to theextended position, wherein the trigger is pivotably coupled to thehousing about a pivot pin, the trigger movable about the pivot pin andrelative to the housing through an arc defined between the un-actuatedand actuated positions, and wherein the first base portion is coupled tothe trigger via a first pin-slot engagement and the second base portionis coupled to the knife via a second pin-slot engagement such thatmovement of the trigger through the arc translates the knifelongitudinally.
 2. The surgical instrument according to claim 1, furtherincluding a movable handle coupled to the housing and movable relativeto the housing to actuate the end effector assembly.
 3. The surgicalinstrument according to claim 2, wherein the movable handle is pivotablycoupled to the housing about the pivot pin.
 4. The surgical instrumentaccording to claim 2, wherein the end effector assembly includes firstand second jaw members, at least one of the first and second jaw membersmovable relative to the other between a spaced-apart position and anapproximated position for grasping tissue therebetween in response tomovement of the movable handle relative to the housing.
 5. The surgicalinstrument according to claim 4, wherein, in the extended position, theknife extends at least partially between the first and second jawmembers to cut tissue grasped therebetween.
 6. The surgical instrumentaccording to claim 4, wherein at least one of the first and second jawmembers is adapted to connect to a source of energy for treating tissuegrasped between the first and second jaw members.
 7. The surgicalinstrument according to claim 4, wherein at least one of the first andsecond jaw members defines a longitudinally-extending knife channelconfigured to at least partially receive the knife therein in theextended position.
 8. The surgical instrument according to claim 7,wherein at least one of the first and second jaw members defines awindow in communication with the longitudinally-extending knife channelthereof, and wherein, in the extended position, the knife extendsthrough the window to protrude from an exterior of the at least one ofthe first and second jaw members.
 9. A surgical instrument, comprising:a housing; a deployable member selectively deployable relative to thehousing; a trigger assembly, including: a trigger pivotably coupled tothe housing about a pivot pin and movable about the pivot pin relativeto the housing through an arc defined between an un-actuated positionand an actuated position; and a linkage defining a triangularconfiguration including an apex portion and first and second baseportions, the apex portion rotatably coupled to the housing about alinkage pivot, the first base portion disposed on a first side of theapex portion and coupled to the trigger via a first pin-slot engagement,the second base portion disposed on a second side of the apex portionand coupled to the deployable member via a second pin-slot engagement,wherein, in response to movement of the trigger through the arc from theun-actuated position to the actuated position, the first base portion ismoved in a first direction, the apex portion is rotated about thelinkage pivot, and the second base portion is moved in a seconddirection opposite the first direction to thereby longitudinallytranslate the deployable member from a retracted position to an extendedposition.
 10. The surgical instrument according to claim 9, wherein thedeployable member is a knife.
 11. The surgical instrument according toclaim 10, further including: a shaft extending distally from thehousing; and an end effector assembly supported at a distal end of theshaft, wherein the knife is slidably disposed within the shaft andconfigured to translate through the shaft and relative to the endeffector assembly between the retracted and extended positions.
 12. Thesurgical instrument according to claim 11, wherein the end effectorassembly includes first and second jaw members, at least one of thefirst and second jaw members movable relative to the other between aspaced-apart position and an approximated position for grasping tissuetherebetween.
 13. The surgical instrument according to claim 12,wherein, in the extended position, the knife extends at least partiallybetween the first and second jaw members to cut tissue graspedtherebetween.
 14. The surgical instrument according to claim 13, whereinat least one of the first and second jaw members defines alongitudinally-extending knife channel configured to at least partiallyreceive the knife therein in the extended position.
 15. The surgicalinstrument according to claim 14, wherein at least one of the first andsecond jaw members defines a window in communication with thelongitudinally-extending knife channel thereof, and wherein, in theextended position, the knife extends through the window to protrude froman exterior of the at least one of the first and second jaw members. 16.The surgical instrument according to claim 12, further including amovable handle coupled to the housing and movable relative to thehousing to move the first and second jaw members between thespaced-apart and approximated positions.
 17. The surgical instrumentaccording to claim 16, wherein the movable handle is pivotably coupledto the housing about the pivot pin.
 18. The surgical instrumentaccording to claim 12, wherein at least one of the first and second jawmembers is adapted to connect to a source of energy for treating tissuegrasped between the first and second jaw members.
 19. A surgicalinstrument, comprising: a housing; a shaft extending distally from thehousing; an end effector coupled at a distal end of the shaft; a knifeslidably disposed within the shaft, the knife configured to translatethrough the shaft and relative to the end effector assembly between aretracted position and an extended position; and a trigger assembly,including: a trigger coupled to the housing and movable relative to thehousing between an un-actuated position and an actuated position; alinkage defining a triangular configuration including an apex portionand first and second base portions, the apex portion rotatably coupledto the housing about a linkage pivot, the first base portion disposed ona first side of the apex portion and coupled to the trigger, the secondbase portion disposed on a second side of the apex portion and coupledto the knife, wherein, in response to movement of the trigger from theun-actuated position to the actuated position, the first base portion ismoved proximally, the apex portion is rotated about the linkage pivot,and the second base portion is moved distally to thereby move the knifefrom the retracted position to the extended position, wherein thetrigger is pivotably coupled to the housing about a pivot pin, thetrigger movable about the pivot pin and relative to the housing throughan arc defined between the un-actuated and actuated positions; and amovable handle pivotably coupled to the housing about the pivot pin, themovable handle movable relative to the housing to actuate the endeffector assembly.